CIALIS Promise™ Program Voucher

Over 300,000 prescriptions filled through voucher program, with approximately 180,000 for CIALIS for once daily use^1†

If you have a patient diagnosed with erectile dysfunction (ED), CIALIS may be right for him. You can help him get started on CIALIS for free with the CIALIS Promise Program.

For your patients with ED who want to attempt sex anytime, day or night,* consider a FREE 30-day supply of CIALIS for once daily use to see if it's right for them. Offer patients a free trial of 30 tablets of CIALIS for once daily use (2.5 or 5 mg), a low-dose tablet taken every day, or 3 tablets of CIALIS for use as needed (10 or 20 mg).

If your patient uses this offer to try CIALIS and you and your patient decide it's not the right ED treatment for your patient, we promise to pay for another CIALIS option or 3 tablets of another prescription ED medication of your patient's choice, as prescribed by you.^‡

It's important to know that there is no other single medication approved to treat both ED and the signs and symptoms of BPH. So if you and your patient decide CIALIS is not right for your patient, we can only offer to pay for an alternative treatment option for your patient's ED.

Click on the links below to learn more about the program.

* Individual results may vary. Not studied for multiple attempts per dose.
^† Based on redemptions through December 2010.
^‡ Offer applies to ED medications only, not other BPH treatments.

How the program works

You write an Rx for a 30-day supply of CIALIS for once daily use or a 3-tablet supply of CIALIS for use as needed.
Your patient obtains a CIALIS Promise Program voucher from you or another source, such as a newspaper ad or CIALIS.com. There is a limit of 1 voucher per patient.
Your patient takes the Rx and voucher to his pharmacy to get his free supply. Get tips for getting patients started on CIALIS for once daily use.
If your patient isn't satisfied with his treatment, he can contact Lilly USA, LLC, to receive a voucher for another CIALIS option or 3 tablets of another PDE5 inhibitor of his choice, as prescribed by you. Learn how the dissatisfaction form works.

How the voucher works

Your patient can pick up a voucher form from your office or another source, such as a newspaper ad. Or, your patient can simply visit CIALIS.com. There, he'll answer a few brief, optional questions about his age and current ED treatment, and then print a voucher packet. No personally identifiable information is collected during the voucher process, and your patient can skip the optional questions if he chooses. There is a limit of 1 voucher per patient.

The voucher packet contains:

A voucher for either 30 tablets of CIALIS for once daily use (2.5 or 5 mg) or 3 tablets of CIALIS for use as needed (10 or 20 mg) that your patient can take to the pharmacy along with his prescription. Get tips for getting patients started on CIALIS for once daily use.
A dissatisfaction form to redeem a voucher for another CIALIS option or 3 tablets of another PDE5 inhibitor if your patient is not satisfied with his free trial treatment experience. Learn how the dissatisfaction form works.
The full CIALIS US Prescribing Information and Patient Information.

What happens if your patient is dissatisfied?

If your patient needs a replacement form, he can contact Lilly USA, LLC. or visit CIALIS.com and take the following steps:

Answer a few brief questions about whether he'd prefer to try another CIALIS option or 3 tablets of a different prescription ED medication as prescribed by you.
Print another dissatisfaction form directly from the site.
Fill out his name, address, and which PDE5 inhibitor option you've prescribed. Please ask your patient to include the dose strength if you previously prescribed the 2.5 mg dose of CIALIS for once daily use and are now titrating to 5 mg.
Mail the form to us at CIALIS Promise Program, P.O. Box 42255, Cincinnati, OH 45242-0255 for receipt by the submit date at the bottom of the original voucher card.

^‡ Offer applies to ED medications only, not other BPH treatments.

Getting patients started on CIALIS for once daily use

CIALIS for once daily use, a low-dose tablet taken every day, may be an appropriate option for your ED patients who want to attempt sex anytime, day or night,* or for those who may want to be ready anytime the moment is right. Here are some tips to help your patients have a positive experience with CIALIS for once daily use:

Help patients understand how the costs of CIALIS for once daily use and CIALIS for use as needed compare. The cost, on average, for 30 tablets of CIALIS 5 mg is $135.^§ Patients may be surprised to find out that a 30-day supply of CIALIS for once daily use should be about the same price as 6 tablets of CIALIS for use as needed.⁴
Instruct patients to take 1 tablet of CIALIS for once daily use at approximately the same time every day.³ Remind patients not to split the tablet and to take CIALIS exactly as directed for the best results. Counsel patients that CIALIS for once daily use may take up to 4 to 5 days to begin working for their ED.^5,6
Remind patients to have their prescriptions filled at an accredited US-based pharmacy to help ensure they receive genuine CIALIS.
When prescribing CIALIS, encourage your patients to visit CIALIS.com to learn as much as possible about treatment with CIALIS.
Encourage patients to monitor and track their results and to share those results with you. If a patient is not satisfied with the 2.5-mg starting dose of CIALIS for once daily use, consider whether titrating to the 5-mg dose of CIALIS for once daily use may be appropriate.³

^§ Estimate is based on national out-of-pocket cost for patients without prescription coverage and average Rx size using SDI VOPA data. SDI's Vector One^®: Payer, December 2011. Please check local pharmacies for actual retail prices, as they may be different, since Lilly does not control the prices at the pharmacy.

The CIALIS Promise Program can help you work with your patient to find the right dose. If your patient started on the program with the 2.5-mg dose and was not satisfied, encourage him to use the dissatisfaction form to redeem another FREE 30-day supply of the CIALIS for once daily use 5-mg option.

Voucher

The CIALIS Promise Program voucher, pictured above, is available for your ED patient to use. Your patient can pick up a form from your office, an advertisement, or CIALIS.com and bring it to his pharmacy along with a prescription from you. Limit 1 per patient. Click on the links above to learn more.

Important Safety Information for CIALIS^® (tadalafil) tablets

CONTRAINDICATIONS

Nitrates: CIALIS is contraindicated in patients using any form of organic nitrate, either regularly and/or intermittently, as the combination could cause a sudden, unsafe drop in blood pressure.

Hypersensitivity Reactions: CIALIS is contraindicated in patients with a known serious hypersensitivity to CIALIS or ADCIRCA^® (tadalafil). Hypersensitivity reactions have been reported, including Stevens-Johnson syndrome and exfoliative dermatitis.

WARNINGS AND PRECAUTIONS

Cardiovascular: Physicians should consider the cardiovascular status of their patients, since there is a degree of cardiac risk associated with sexual activity. Treatments for erectile dysfunction (ED), including CIALIS, should not be used in men for whom sexual activity is inadvisable as a result of their underlying cardiovascular status. Patients who experience symptoms upon initiation of sexual activity should be advised to refrain from further sexual activity and seek immediate medical attention.

PDE5 inhibitors, including CIALIS, are mild systemic vasodilators. While this effect should not be of consequence in most patients, physicians should consider this potential when prescribing CIALIS.

Patients with left ventricular outflow obstruction (e.g., aortic stenosis and idiopathic hypertrophic subaortic stenosis) can be sensitive to the action of vasodilators, including PDE5 inhibitors.

CIALIS was not studied and is not recommended in patients who have recently suffered a heart attack (within 90 days) or stroke (within 6 months), or patients with uncontrolled hypertension, hypotension, uncontrolled arrhythmias, heart failure (New York Heart Assocation [NYHA] ≥Class 2 in last 6 months), unstable angina or angina occurring during sexual activity.

Potential Drug Interactions: CIALIS can potentiate the hypotensive effects of alpha-blockers, antihypertensives or substantial amounts of alcohol (≥5 units). CIALIS is not recommended in combination with alpha-blockers for the treatment of benign prostatic hyperplasia (BPH) symptoms because efficacy of the combination has not been adequately studied and due to the risk of blood pressure lowering. Caution is advised when CIALIS is used as a treatment for ED in men taking alpha-blockers. CIALIS for once daily use provides continuous plasma tadalafil levels. Physicians should consider this when evaluating the potential for interactions.

Combination with other PDE5 inhibitors: CIALIS is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Instruct patients not to take CIALIS in combination with ADCIRCA or other PDE5 inhibitors.

Potent inhibitors of CYP3A4: For patients taking potent inhibitors of CYP3A4, dose should be adjusted: CIALIS for use as needed: 10 mg no more than once every 72 hours. CIALIS for once daily use: the maximum recommended dose is 2.5 mg.

Prolonged Erection: There have been rare reports of priapism with this class of compounds. Patients should be advised to seek immediate medical attention should this occur. Use CIALIS with caution in patients who have conditions that might predispose them to priapism.

Vision/Hearing: The following events have been reported in men taking PDE5 inhibitors including CIALIS: (1) sudden decrease or loss of vision in one or both eyes; (2) sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness. It is not possible to determine whether these events are related directly to the medicines, other health conditions, or to a combination of these. If a patient experiences a sudden decrease or loss in vision or hearing he should stop taking CIALIS, and call a healthcare provider right away. Patients with known hereditary degenerative retinal disorders, including retinitis pigmentosa, were not included in the clinical trials, and use in these patients is not recommended.

Specific Populations: Creatinine clearance less than 30 mL/min or on hemodialysis: CIALIS for daily use is not recommended; CIALIS for use as needed- 5 mg not more than once every 72 hours. Creatinine clearance 30 to 50 mL/min: For CIALIS for daily use treatment of BPH or ED/BPH, start dosing at 2.5 mg and increase to 5 mg based upon individual response. CIALIS for use as needed- 5 mg not more than once per day with maximum dose 10 mg not more than once every 48 hours. Severe hepatic impairment: Use of CIALIS is not recommended. Mild or moderate hepatic impairment: CIALIS has not been extensively evaluated in patients with mild or moderate hepatic impairment; caution is advised if CIALIS is prescribed to these patients. With CIALIS for use as needed, dose should not exceed 10 mg. Additional dose adjustments may be required for patients with other concomitant medications. See full Prescribing Information for complete dosing instructions.

Sexually Transmitted Diseases: The use of CIALIS offers no protection against sexually transmitted diseases. Counseling patients about the protective measures necessary to guard against sexually transmitted diseases, including Human Immunodeficiency Virus (HIV) should be considered.

Consideration of Other Urological Conditions Prior to Initiating Treatment for BPH: Prior to initiating treatment with CIALIS for BPH, consideration should be given to other urological conditions that may cause similar symptoms. In addition, prostate cancer and BPH may coexist.

ADVERSE REACTIONS

Most common adverse reactions (≥2%) with CIALIS for once daily use vs placebo, respectively, include:

In ED (2.5 and 5 mg): headache (3% and 6% vs 5%), dyspepsia (4% and 5% vs 2%), nasal congestion (2% and 2% vs 0%), flushing (1% and 3% vs 1%), and pain in extremity (1% and 2% vs 0%). Back pain (3% and 3% vs 1%) and myalgia (2% and 2% vs 1%) were also reported, sometimes with delayed onset.

In BPH and ED/BPH (5 mg): headache (4.1% vs 2.3%), dyspepsia (2.4% vs 0.2%), nasopharyngitis (2.1% vs 1.6%). Back pain (2.4% vs 1.4%) was also reported, sometimes with delayed onset.

Most common adverse reactions (≥2%) with CIALIS for use as needed in ED (5 mg, 10 mg, and 20 mg) vs placebo, respectively, include: headache (11%, 11%, and 15% vs 5%), dyspepsia (4%, 8%, and 10% vs 1%), nasal congestion (2%, 3%, and 3% vs 1%), flushing (2%, 3%, and 3% vs 1%), and pain in limb (1%, 3%, and 3% vs 1%). Back pain (3%, 5%, and 6% vs 3%) and myalgia (1%, 4%, and 3% vs 1%) were also reported, sometimes with delayed onset.

For more complete information, please see full Prescribing Information and Patient Information.

TD HCP ISI 24JAN2012

References

Data on file. Lilly USA, LLC: CIA 20110127A.
Data on file. Lilly USA, LLC: CIA20111129A.
Cialis [package insert]. Indianapolis, IN: Eli Lilly and Company; 2011.
Data on file. Lilly USA, LLC: CIA20120208A.
Data on file. Lilly USA, LLC: CIA20110212A.
Seftel A, Goldfischer E, Kim ED, Dula E, Zeigler H, Burns P. Onset of efficacy of tadalafil once daily in men with erectile dysfunction: a randomized, double-blind, placebo-controlled trial. J Urol. 2011;185:243-248.

Select Important Safety Information